Post-Cholecystectomy Syndrome

The gall bladder (Latin: vesica fellea or vesica basilaris) is the storage organ for the bile and has a storage capacity of 40 – 50 ml. On its way from the liver to the duodenum, the bile runs through a duct system which is referred to as the bile ducts. The function of the gall bladder and the bile ducts is an elementary prerequisite for the complex process of digestion and can be impaired by typical diseases which a physician should know and understand. In order to understand the process of digestion, the spleen and the pancreas are also important.

00:01
Post-cholecystectomy syndrome. Now
that your gallbladder has been removed,persistent right upper quadrant pain
with nausea and vomitingafter cholecystectomy that mimics
pre-op symptoms, you will find thisin a number of your patients.
00:19
And if you have not properly
educated your patient,they have no idea what’s going on
because they don’t know what to expect.
00:26
But if you tell them, follow up, and say,
“Listen, there is every possibility.
00:31
I have just performed the surgery.
I removed your gallbladder.
00:35
This is why you needed it. But the body
would take a little bit of time to adapt,so therefore, you might still have
the same symptoms as whatyou were experiencing prior. It’s
important that you know the definition.
00:48
It happens more often than we would like."Causes are the following. You have
now just introduced surgery intoa very delicate portion of the body
known as the GI system.
01:03
Anytime that you introduce surgery,
for example, invasive laparoscopy.
01:07
Here, obviously, cholecystectomy, there’s
every possibility that you might then causefibrosis, stenosis, papillary stenosis,
retained stone in the common bile ductpossibly, bile duct injury itself
or biliary dyskinesia.
01:24
You’ve messed up the rhythm.
Not that you wanted to, but everypatient is going to respond
a little bit better.
01:30
In an idealistic world, it’d be great
to remove the gallbladder, andthe patient never having symptoms again.
The chances of that is so slim.
01:43
Complications are unfortunately
a true part of life and it's importantthat you make sure that you properly
educate your patient because now,if you don’t, that patient is going to
come after you with the lawyer.
01:57
Management, ERCP.

About the Lecture

The lecture Post-Cholecystectomy Syndrome by Carlo Raj, MD is from the course Pancreatic and Biliary Tract Diseases.

Included Quiz Questions

Which of the following is NOT a complication associated with surgical removal of the gallbladder?

Choledochal cysts

Papillary stenosis

Retained stone in the common bile duct

Bile duct injury

Biliary dyskinesia

A patient presents with a persistent increase in total bilirubin after cholecystectomy. ERCP was done which ruled out any obstruction. What is the probable cause for a persistent increase in total bilirubin levels?

Biliary dyskinesia

Post cholecystectomy scarring

Retained stone in the biliary tract

Bile duct obstruction

Papillary stenosis

Author of lecture Post-Cholecystectomy Syndrome

Carlo Raj, MD

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